The satisfaction of the members and providers associated with SmartHealth is of paramount importance. It is expected that individuals be treated with compassion, competence, and meticulous follow up. The position of client service manager is to organize the administration of these values. The position will include extensive interaction with the SmartHealth clients at the management/decision making and individual level. Client satisfaction will be achieved by providing accurate, timely and responsive service to questions or complaints. Interaction with other departments is necessary to coordinate the closure of all client concerns. The manager will take the lead in developing educational programs that translate benefits into lay-person language that will be placed in communications and on the website.
- Act as liaison between the client and all departments within SmartHealth and the various third party administrators (TPA).
- Attend SmartHealth and TPA meetings as needed.
- Develop and implement educational programs that translate benefits into lay-person language.
- Develop and implement educational programs based on concerns brought by the clients in a ‘lessons learned’ format.
- Resolve all billing and enrollment issues internally and with the client.
- Serve as a member of the new group implementation team.
- Cross train in all aspects of job with USHL and ABS
- Answer any questions regarding policy, procedures, payments and benefits made on behalf of the client.
- Receive and disburse plan changes or renewal selection by the client within the company
- Periodic client visits and training, addressing complaints and solving problems
- Attend implementation meetings, enrollment meetings, and process new group information
- Train and assist client in on line capabilities and new features offered by SmartHealth
- Resolve client issues immediately by involving upper management when needed.
- Develop and implement monthly activity reports that reflect the type of concerns managed, time to resolution and other metrics as appropriate.
- Other tasks and responsibilities as required by management.
- Assist in planning, decision making, and facilitating process improvement
- Prioritize and plan meetings to generate suggestions for improving service to our clients
- Learn about each department within the company to assist clients as they call in without having to rely on other departments before returning calls to the client
- Associate Degree in Nursing required; must be a Licensed Practical Nurse licensed to practice in the State to Michigan.
- Must have experience in medical management, utilization management or similar type of work
- PPO/HMO background preferred.
- Ability to set priorities, organize work, gather, interpret and analyze clinical data and recommend medical services based on analysis.
- Good interpersonal and communication skills, verbal and written.
- Good presentation skills.
- Proficient in the use of a computer. Microsoft Office Products usage preferred.
Ascension Health - 2 years ago
Ascension Health has ascended to the pinnacle of not-for-profit health care. As the largest Catholic hospital system in the US, and thus one...